Problem-Based Learning

Developed by Barrows1 and colleagues at McMaster University, ON for medical education, PBL is a rigorous,
highly structured teaching methodology which places the student in a position of active
responsibility for learning and mastering content. In a group of peers, the student
learns new material by confronting and solving problems in the form of a clinical
patient case. Barrows and colleague demonstrated that PBL effectively helps students
to develop scientific thinking about patients’ problems and to acquire both foundational
science and clinical information in a manner that ensures retention and transfer [of
learning] to the real-life task of the clinician.1Recent studies indicate that graduates of problem-based health care educational programs
perform well (most studies indicate better than students from more traditional educational
programs) on board exams and exhibit secure clinical learning and reasoning skills
to the betterment of their patients.

Since the acquisition of new material revolves around a patient case, students constantly
learn and apply information in the context of solving a patient problem. For example,
students might be required to answer the following questions posed by the tutor: based
on the pathophysiology of his disease process, what precautions would be important
when treating this patient? How would you handle the patient’s emotional affect in
order to accomplish your treatment? How might the patient’s medications influence
the outcome of today’s intervention? What tests and measures might be appropriate
for the patient given their current status?

Through the PBL process, students are learning how to ask questions and to research
the answers. Students become skillful at database searching, critiquing journal articles,
and synthesizing information from a variety of sources. Since group members are dependent
on each other for enriching discussion and subsequent learning, each student must
participate in PBL sessions, whether by volunteering information, asking questions,
seeking clarification, confirming the thoughts of a peer, or relating information
to the patient case. Inherent in the PBL process, students learn how to function
as individual members of a team, conferring for the greater good (learning the material/treating
the patient). Students also have an opportunity to evaluate the participation skills
of their classmates (preparation, clinical reasoning, quality of learning resources,
team skills, respective listening) and themselves, in written and oral formats. This
teaches critical reflection and the skills of providing/receiving constructive criticism.